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Mariusz Sikora, Magdalena Chrabąszcz, Cezary Maciejewski, Michał Zaremba, Anna Waśkiel, Małgorzata Olszewska, Lidia Rudnicka
Psoriasis is a chronic inflammatory systemic disease. Growing evidence suggests that human homeostasis depends on a mutualistic relationship with gut bacteria that produce a number of biologically active compounds. Therefore, enteric microbiota dysbiosis with gut barrier disruption may be an important factor in the development of chronic inflammatory diseases. The aim of our study was to assess non-invasive markers of intestinal barrier integrity in patients with moderate to severe psoriasis. Concentrations of claudin-3 (intestinal epithelial tight junction structure) and intestinal fatty acid binding protein (I-FABP; marker of enterocyte damage) were determined in the blood of patients with chronic plaque psoriasis (n = 20) and healthy individuals (n = 20) using commercially available enzyme-linked immunoassay test kits...
September 17, 2018: Journal of Dermatology
Giuseppina Abignano, Gianna A Mennillo, Giovanni Lettieri, Angela Padula, Dennis McGonagle, Salvatore D'Angelo
A 40-year-old gentleman was diagnosed with anti-topoisomerase-I antibody positive diffuse cutaneous systemic sclerosis (SSc). Raynaud's phenomenon, diffuse skin sclerosis and severe interstitial lung disease (ILD) were the onset features causing digital ischemia, disability and dyspnea. He subsequently developed inflammatory polyarthritis (IA) with hands and wrists involvement. His brother had psoriasis. Physical examination showed fingertip pitting scars, subcutaneous calcinosis, skin sclerosis with hyper- and hypopigmentation, flexion and extension contractures and shortened fingers (Figure 1...
September 17, 2018: Arthritis & Rheumatology
Peng-Yang Hsu, Hui-Ju Yang, Tao-Hsiang Yang, Che-Chun Su
Psoriasis is a chronic autoimmune disease with keratinocyte activation and lymphocyte infiltration in the skin. Our previous study found that 5-hydroxytrytophan (5(OH)Trp), a tryptophan metabolite alleviated collagen-induced arthritis and suppressed cytokine production. In this study, we evaluated the effects of 5(OH)Trp in a mouse model for psoriasiform dermatitis, induced by imiquimod (IMQ). We showed that 5(OH)Trp significantly reduced the cumulative scores, epidermal thickness, and ki-67 expression in the skin...
September 16, 2018: Experimental Dermatology
Laura C Coates, Ennio Lubrano, Fabio Massimo Perrotta, Paul Emery, Philip G Conaghan, Philip S Helliwell
OBJECTIVE: Recommendations regarding "treat to target" in psoriatic arthritis (PsA) have stated that the target should be remission or inactive disease. Potential definitions include very low disease activity (VLDA), PsA Disease Activity Score (PASDAS) near remission, Disease Activity Index for PsA (DAPSA) or clinical DAPSA (cDAPSA) remission. Our aim was to investigate the proportion of patients who fulfill these definitions and how much residual active disease remained. METHODS: This analysis used 2 datasets: first, trial data from the Tight Control of PsA (TICOPA) study, which included 206 patients with recent-onset (< 2 yrs) PsA receiving standard and biological disease-modifying antirheumatic drugs (DMARD); and second, an observational clinical dataset from Italy of patients receiving biological DMARD...
September 15, 2018: Journal of Rheumatology
Lommers Emilie, Depierreux Frédérique, Hansen Isabelle, Dive Dominique, Maquet Pierre
Tumor necrosis factor α (TNFα) inhibitors are highly effective and a therapeutic choice for several inflammatory diseases. Their broad and long-term use is associated with a growing number of paradoxical autoimmune events including demyelinating lesions of the central nervous system (CNS). We report and discuss a case of neuromyelitis optica spectrum disorder (NMOSD) with positive myelin oligodendrocyte glycoprotein antibodies (MOG-IgG1) following anti-TNFα therapy for a pustular psoriasis.
August 31, 2018: Multiple Sclerosis and related Disorders
Lenche Chakievska, Maike M Holtsche, Axel Künstner, Stephanie Goletz, Britt-Sabina Petersen, Diamant Thaci, Saleh M Ibrahim, Ralf J Ludwig, Andre Franke, Christian D Sadik, Detlef Zillikens, Christoph Hölscher, Hauke Busch, Enno Schmidt
IL-17A has been identified as key regulatory molecule in several autoimmune and chronic inflammatory diseases followed by the successful use of anti-IL-17 therapy, e.g. in ankylosing spondylitis and psoriasis. Bullous pemphigoid (BP) is the most frequent autoimmune blistering disease with a high need for more specific, effective and safe treatment options. The aim of this study was to clarify the pathophysiological importance of IL-17A in BP. We found elevated numbers of IL-17A+ CD4+ lymphocytes in the peripheral blood of BP patients and identified CD3+ cells as major source of IL-17A in early BP skin lesions...
September 12, 2018: Journal of Autoimmunity
Yan Wu, Liu Liu, Chunxiang Bian, Qingchun Diao, Muhammad Farrukh Nisar, Xuemei Jiang, Jörg W Bartsch, Maojiao Zhong, Xiangyu Hu, Julia Li Zhong
BACKGROUND: The extensive involvement of microRNA (miRNA) in the pathophysiology of psoriasis is well documented. However, in order for this information to be useful in therapeutic manipulation of miRNA levels, it is essential that detailed functional mechanisms are elucidated. This study aimed to explore the effects of IL-6 targeting by let-7b and ERK1/2 mediated signaling on keratinocyte differentiation in psoriasis. METHODS: Following imiquimod cream (IMQ) application to let-7bTG (keratinocyte-specific let-7b overexpression mouse) and control mice for 7 days, we analyzed erythema, scaling and thickening of skin...
September 15, 2018: Cell Communication and Signaling: CCS
C Fink, C Alt, L Uhlmann, C Klose, A Enk, H A Haenssle
BACKGROUND: The Psoriasis Area and Severity Index (PASI) represents the gold standard for psoriasis severity assessments but is limited by its subjectivity and low intra- and inter-rater consistency. OBJECTIVE: To investigate the precision and reproducibility of automated, computer-guided PASI measurements (ACPMs) in comparison to three trained physicians. METHODS: Comparative observational study assessing ACPMs attained by automated total body imaging (ATBI) and computerized digital image analysis in a cohort of 120 patients affected by plaque psoriasis of various severities...
September 15, 2018: British Journal of Dermatology
Kathryn P Trayes, Katherine Savage, James S Studdiford
Annular lesions can present in a variety of diseases. Knowledge of the physical appearance and history of presentation of these skin findings can help in the diagnosis. A pruritic, annular, erythematous patch that grows centrifugally should prompt evaluation for tinea corporis. Tinea corporis may be diagnosed through potassium hydroxide examination of scrapings. Recognizing erythema migrans is important in making the diagnosis of Lyme disease so that antibiotics can be initiated promptly. Plaque psoriasis generally presents with sharply demarcated, erythematous silver plaques...
September 1, 2018: American Family Physician
Curtis Hardy, Jonathan Glass
Vaccines have a well-demonstrated therapeutic benefit. However, the spectrum of potential dermatologic vaccine side effects ranges from localized skin irritation to acute and delayed response. Currently, there are limited published data correlating dermatoses with alterations in the immune system following vaccination. The mechanism by which group A beta-hemolytic streptococci may precede the manifestation of guttate psoriasis is included as a mechanism foundation as we further describe the immunopathogenesis of immune-mediated linear dermatoses...
September 12, 2018: Military Medicine
Jared Khan, Sandhya Chowdary Deverapalli, David Rosmarin
Cutaneous inflammatory conditions such as psoriasis, atopic dermatitis, alopecia areata, vitiligo, and connective tissue diseases often remain a challenge to treat. Although there is an in-depth understanding of the clinical presentation of these diseases, much less is known regarding the pathophysiology. This has limited the effective treatment options for patients. A more detailed understanding of the pathogenesis of each disease will lead to newer targeted medications with less morbidity. Though there are different pathways involved in these diseases, the Janus Kinase (JAK)-Signal Transducer and Activator of Transcription proteins (STAT) signaling pathway is common to them all...
September 2018: Seminars in Cutaneous Medicine and Surgery
Scott A Elman, Michael Weinblatt, Joseph F Merola
Dermatologists are on the front line to identify psoriatic arthritis (PsA) in their patients with psoriasis. PsA is a prevalent and underdiagnosed disease with potential long-term complications and sequelae for patients. Targeted biologics have transformed the landscape of psoriasis and PsA therapy. These medications variably treat clinical manifestations of psoriatic disease: skin psoriasis, peripheral and axial arthritis, enthesitis, and nail disease. With many new medications either on the market or currently being evaluated by the Food and Drug Administration, the purpose of this article is to review PsA for the dermatologist, to identify the current therapies that are available, and to help select which patients may benefit from these medications...
September 2018: Seminars in Cutaneous Medicine and Surgery
Gene Schwartz, Amy S Paller
Children who are recalcitrant to topical therapy for their moderate to severe plaque psoriasis and/or highly visible lesions may be candidates for systemic therapy. Methotrexate has been the most commonly used systemic agent in children. However, at least 25% of patients are now treated with biologics, especially tumor necrosis factor-α inhibitors, and their use is expanding as their availability, demonstrated safety and efficacy, and practitioner experience are increasing. In the United States, etanercept is Food and Drug Administration approved for ages 6 years and older and ustekinumab for 12 years of age and older...
September 2018: Seminars in Cutaneous Medicine and Surgery
Sanminder Singh, April W Armstrong
Psoriasis is chronic inflammatory skin condition that imposes a significant physical and psychosocial burden on patients. Moderate to severe psoriasis often requires systemic treatments, including oral systemic therapies and biologics. An addition to the treatment repository for psoriasis is oral small molecules, which include apremilast, tofacitinib, and ponesimod. Of these 3 medications, only apremilast is currently approved for the treatment of psoriasis. Long-term safety data for apremilast suggest that it has a tolerable safety profile and leads to significant improvement in patients with psoriasis; however, there are few head-to-head comparisons with other oral systemic medications...
September 2018: Seminars in Cutaneous Medicine and Surgery
Erin Ibler, Kenneth B Gordon
Since the identification of high levels of interleukin 23 (IL- 23) in psoriasis lesional skin, as well as finding that IL-23 was the most important source of the p40 subunit shared by IL-12 and IL-23, significant effort has been made in identifying potential new drugs that specifically block the unique IL-23 p19 subunit. At this time, 2 inhibitors of IL-23 p19 have been approved by the United States Food and Drug Administration, guselkumab and tildrakizumab. Two other agents, risankizumab and mirikizumab, have completed phase 3 and phase 2 of development, respectively...
September 2018: Seminars in Cutaneous Medicine and Surgery
So Yeon Paek, Jillian Frieder, Dario Kivelevitch, M Alan Menter
The role of the Th17/interleukin (IL)-23 pathway has been well elucidated in psoriasis. The IL-17 family includes 6 cytokines: IL-17A, IL-17B, IL-17C, IL-17D, IL-17E, and IL-17F. Two monoclonal antibodies targeting IL-17A (secukinumab, ixekizumab) and one antibody against the IL-17 receptor (brodalumab) have been approved for the treatment of moderate-to-severe plaque psoriasis. Clinical efficacy, safety, and tolerability of each agent is reviewed.
September 2018: Seminars in Cutaneous Medicine and Surgery
Zenas Zn Yiu, Richard B Warren
Ustekinumab is an interleukin-12/23 inhibitor used for the treatment of moderate-to-severe psoriasis. Here, we review new evidence since ustekinumab was licensed for relative efficacy in comparison with other biologic therapies from head-to-head randomized controlled trials and network meta-analyses for the treatment of psoriasis. We also review observational data emerging from psoriasis registries reporting the effectiveness and safety of ustekinumab. Overall, new evidence suggests that ustekinumab has a favorable balance between efficacy/effectiveness, safety, and tolerability and should remain a first-line biologic therapy option for patients with severe psoriasis at present...
September 2018: Seminars in Cutaneous Medicine and Surgery
Margot Chima, Mark Lebwohl
Tumor necrosis factor (TNF)-α has been identified as a key cytokine mediating cutaneous inflammation in the pathogenesis of psoriasis. The TNF inhibitors (TNFi's) infliximab, adalimumab, and etanercept are efficacious, Food and Drug Administration-approved medications for the treatment of moderate-to-severe plaque psoriasis. Each drug has a unique pharmacological profile that can have therapeutic implications when choosing a particular TNFi for a patient. An understanding of these idiosyncrasies can help guide therapeutic decisions for patients with psoriasis that also have inflammatory bowel disease, hepatitis C, hepatitis B, latent tuberculosis, obesity, cardiovascular disease, and heart failure...
September 2018: Seminars in Cutaneous Medicine and Surgery
M Augustin, I Schäfer, R Sommer
In the dermatology practiced in Germany, healthcare research is an established and highly differentiated discipline. In many university dermatological institutions and private practices, studies are carried out on the processes of healthcare research for skin diseases. Commissioned by the German Society of Dermatology and the Professional Association of German Dermatologists, a significant number of the studies and projects are conducted by the German Center for Health Services Research in Dermatology (CVderm) as a nationwide reference center...
September 13, 2018: Der Hautarzt; Zeitschrift Für Dermatologie, Venerologie, und Verwandte Gebiete
R Sommer, U Mrowietz, N Zander, M Augustin
No abstract text is available yet for this article.
September 13, 2018: Der Hautarzt; Zeitschrift Für Dermatologie, Venerologie, und Verwandte Gebiete
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